Category Archives: chiropractic practice development

Sage on the Stage or Guide from the Side: Chiropractic Seminars vs. Coaching – Which is Better?

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They both can be expensive, so what service gives the greatest “bang for the buck?”

I go to seminars. I like them. In fact, I hope to see some of you at the WAVE, sponsored by Life West  in San Francisco this weekend (8/1/2014).   (If you are going please contact me by calling the office number below and it will forward to my phone. It would be great to say “hi” in person!)

Seminars provide a good opportunity to get away. B.J. Palmer talks about this, of course, in his Rule Number #9. (1)

Also, by disengaging from your work, you can better re-engage in it when you get back. The science of this is discussed in a book called: The Power of Full Engagement.

Plus, networking. Nothing like meeting new people and hearing how and what they are doing and trading fish stories – even if they are often embellished.  (“Don’t tell fish stories where the people know you; but particularly, don’t tell them where they know the fish.” Attributed to Mark Twain.)

And, they can be entertaining.

Plus, you can learn things. Learning new things that work and unlearning things that don’t work is probably the MOST important skill you can have. And it is getting more important every day. Our world is changing SO fast that in order to keep up, you have to really spend time and money learning.

“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.” ― Alvin Toffler

However, there are drawbacks.

Seminars: the Sage on the Stage

First, there is the expense of the seminar.  Actually, by comparison, most chiropractic seminars are dirt cheap compared to other seminars that run into the thousands. The expense is in the travel. The hidden expenses add up considerably, especially if you take your staff, which you should now and then.

Then, there is the actual content – the information being imparted.  Much of it is motivational and that is nice.  However, the seminar speaker does not know you. He hasn’t been to your office, your home, talked with your staff or know your family. He hasn’t read your town’s newspaper or seen your patients.  He doesn’t know your situation.  He teaches you a procedure that sounds good in theory and may have even worked in his office 15 years ago, for a while.  He may be entertaining, or coercive.  But, often only 10% of what is taught at a seminar is applicable to you and your office.  And of that, very little gets implemented, and in two months, less than 5% of the seminar may be in operation at your office.   The following is an example that shows how much useful information gets reduced down to actual implementation in most offices.

Actual Value of Seminar (approximate percentages)

  • Motivational (can sometimes be excellent, but is very temporary.)
  • Percent of information verifiably valid:  70%
  • Percent of information comprehensible, heard, or understood: Of the 70%, one half is comprehended, heard, or understood, leaving 35%)
  • Percent of information applicable to your particular city, staff, patient base, your style and personality, etc.: Of that 35%, perhaps 15% isn’t applicable, leaving you with 20%.
  • Percent of information that can be implemented in your office: Of the remaining 20%, perhaps only half can get applied, leaving 10%.
  • Percent of information that gets applied:  In two weeks time, only 5% gets applied.
  • Percent of information that stays in application: After two months, only 1-5% percent of the original information is still applied.
  • If you had spent $2,000 on a seminar program, using the rough example above, you would have wasted all but 5%, or $1,900.

This example is a little harsh, I‘ll admit, but I wanted to make a point. But you know what? Even this small percent may still be worth attending the seminar.

Coaching – The Guide from the Side

Our company grew because doctors did not or could not adequately apply what they heard at the seminars.  Starting out many years ago, I remember seeing doctor’s shelves full of binders, VHS cassettes, and manuals that were barely touched since they were brought home from the seminar.

So, back in the late 1980’s, we came up with our niche and our identity, encapsulated in our tag line:

When Seminars Aren’t Enough sm

Good coaching, helps you and helps your team discover what systems work best for you, and then helps you make them better – over and over until your TEAM becomes expert.

A good coach, like a competent doctor, has the experience to quickly identify what needs to be worked on that can bring about the quickest improvements.  This is what we do.  We have become skilled at spotting the key leverage points (3) in an office and have developed new and effective methods to make the changes necessary for faster improvements.

But, we do this as your guide. We don’t impose a particular patient system into your office.  You are unique and what works for a doctor in Nebraska may not work for the same one in San Diego.  We help you discover what works best for you and help your team get better at supporting you.

A good coach trains, advises, nudges, listens, counsels, teaches, and when possible, even does some of the work.  And is this effective? You sure as hell bet it is! We have been doing this for nearly 30 years and those doctors that have worked with us know this to be true.

But the real reason for coaching is economics: bottom line, baby! Return on Invest. ROI.  Studies show a pay back of 5 to 7 times on your investment. We have certainly seen this occur. (3)

Like chiropractic, good care doesn’t cost, IT PAYS. Health IS wealth.  The same applies to education – and in particular – coaching. It doesn’t cost – it pays.

Seminars? Yes. Coaching? Hell yes!  But books and webinars and mentors as well.  A weekend of reading a book is a great investment.

In the end, you have to constantly study and learn to stay in the game. Success is, now more than ever, dependent upon constant never ending improvement.  You have to do this just to keep up, let alone to get ahead.

And if you don’t – well, your community and patients will be seeking a healthcare office that is.

References
(1)    Rule #9:  Every man owes it to himself, his people and his service to go away about every so often. The more detail he has, the oftener he should go. The more worries, the more he needs to go. The bigger his work, the longer his vacation should be. – B.J. Palmer    https://pmaworks.com/observations/2008/08/18/getting-away-rule-9/

(2)    Leverage Points  http://www.donellameadows.org/wp-content/userfiles/Leverage_Points.pdf , also: Eli Goldratt, The Goal

(3)    BUSINESS IMPACT STUDIES

  • Research conducted by MetrixGlobal on coaching at a Fortune 500 company showed that coaching produced a 529% return on investment and significant intangible benefits to the business. Including the financial benefits from employee retention boosted the overall ROI to 788%.
  • A landmark study commissioned by Right Management Consultants found a return-on-investment of dollars spent on executive coaching of nearly 600%. Executives engaged in coaching reported increases in productivity, improvement in relationships with direct reports and colleagues and greater job satisfaction.
  • According to a study by the Manchester Consulting Group, organizational benefits from executive coaching include:

Improved Relationships 77%
Improved Teamwork 67%
Improved Job Satisfaction 61%
Improved Productivity 53%

  • An International Personnel Management Association survey found that productivity increased by 88 percent when coaching was combined with training (compared to a 22 percent increase with training alone).
  • Studies completed by the American Society for Training and Development showed a ROI of 5 times the cost of coaching.

BUSINESS PRESS EXCERPTS

  “Many of the world’s most admired corporations, from GE to Goldman Sachs, invest in coaching. Annual spending on coaching in the United States in estimated at roughly $1 billion.”   Harvard Business Review

  “Coaches are not for the meek. They’re for people who value unambiguous feedback. All coaches have one thing in common. It’s that they are ruthlessly results-oriented.”          Fast Company Magazine

  “Business coaching is attracting America’s top CEO’s because, put simply, business coaching works. In fact, when asked for a conservative estimate of monetary payoff from the coaching they got….managers described an average return of more than $100,000 or about six times what coaching had cost their companies.”                                   Fortune Magazine

   “[A Coach] is part advisor, part sounding board, part cheerleader, part manager and part strategist.”    The Business Journal

   “Between 25 percent and 40 percent of Fortune 500 companies use executive coaches.”      The Hay Group International

  “Once used to bolster troubled staffers, coaching now is part of the standard leadership development training for elite executives and talented up-and-comers at IBM, Motorola, J.P. Morgan, Chase, and Hewlett Packard. These companies are discreetly giving their best prospects what star athletes have long had: a trusted adviser to help reach their goals.”                     CNN.com

  “In a 2004 survey by Right Management consultants, 86% of companies said they used coaching to sharpen skills of individuals who have been identified as future organizational leaders.”         Harvard Management Update

  “A coach may be the guardian angel you need to rev up your career.”          Money Magazine

http://transverseleadership.com/roi.html

Chiropractic Team Tryouts: Tips on Interviewing Potential New Team Members

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tryout
 Tryout: a test of someone’s ability to do something that is used to see if he or she should join a team, perform in a play, etc. (Merriam-Webster)

 

We routinely help our chiropractic teams with the hiring process.

Getting the right players can make all the difference in whether you are a winning team or just a mediocre one.

 It is often difficult to find the right candidate for the job. The prospective employee is trained to be sweet at the interview and have an impressive resume and you are expected to ask her just the right questions that will evoke her true character. This is usually not adequate.

In addition to interviews, practical tests that challenge candidates for the job position can be included as part of the hiring process. Much like a “tryout” for any sport team, musical group, or an audition for a play, we want to see how the prospective new employee performs.

A good management motto is: “Look, don’t listen.” This definitely applies to hiring.

After the first interview, if you are still interested in the person, have them come in again for a practical interview. This is the “tryout” or audition. For the front desk position, present them with some challenging but common situations and have them demonstrate how they would handle each. Have them demonstrate as in role playing, not just tell you how they would do it.

 In the examples below, the doctor can be in the role of the patient, or prospective patient, or have another team member in that role.

For the Front Desk position, you can have the candidate take on the following situations:

  •  Appointment book is full. Patient calls in and wants to see the doctor.
  • Patient calls in and is in pain.
  • Calls but is skeptical of chiropractic
  • Calls, asks how much for an adjustment, and then says it costs too much
  • Patient is leaving after an adjustment, needs to be scheduled, and the phone is ringing.
  • Patient owes $37.67. Collect it.
  • Promoting upcoming talk, next Tuesday at 6:30 on “Spinal Fitness.”

Someone applying for Patient Accounts could role-play the following:

  • Perform a patient financial consultation on a new Medicare patient who also has a secondary.
  • Call for chiropractic benefits.
  • Receive a letter “not medically necessary.” What actions to take?
  • Promoting upcoming talk, next Tuesday at 6:30 on Spinal Fitness.

Other situations can be presented that are appropriate for your office, depending on the position, such as therapy, external marketing, etc. Be creative and keep it fun, but challenging.

You can give the candidate a few lines to help them, but tell them you want them to improvise to the best of their ability. It doesn’t have to be perfect and probably won’t be that smooth as they are new to your office.

What you are looking for is their ability to be genuinely interested in the patient. You want to see how much in command they are of the situation, their friendliness, compassion, and general quality of their communication.

If you want a winning team, when hiring, use “Tryouts.”

GOOD TO GREAT: The 1st Step in Taking Your Chiropractic Office to Greatness

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Jim Collins, author of Good to Great, after researching many successful companies, noted that great companies “confronted the brutal facts.”

Cover_Good_2_Gr8

“All good-to-great companies began the process of finding a path to greatness by confronting the brutal facts of their current reality.”

If you want to take your chiropractic business to the next level —the 1st thing you need is an exact and honest picture of where you are now.

You see, you can’t get to “THERE” if you aren’t exactly clear on where “HERE” is.

You may be looking at where you want to go — visualizing your goals — and you should. But before you head out on your path you should really look at where you are now and review your strengths and weaknesses.

It is goal setting season now. If you don’t clearly assess your current practice condition, a year from now you may be right back where you started.

In a hurry to get THERE, we often don’t spend enough time really LOOKING at and assessing what is honestly going on HERE.  In fact, it has been our experience that most doctors do not face the blunt facts right in front of them but instead try to “solve” their practice challenges with a new solution.   It is similar to a patient embarking on a new treatment program without first receiving a thorough examination.

We have often seen a doctor set goals designed to fix a challenging practice situation in one area when the problem was really emanating from another.  For example, your external new patient difficulty may really be coming from messes in your office management.

How is your front desk team member doing (really) after her husband lost his job? What is going on with that therapy procedure you wanted to implement three months ago? Is my billing coordinator writing off too much? How many new procedures has the front desk been given over the last 6 months? How much money am I spending/not spending on marketing? What’s going on with our newsletter program? Where’s my blue coffee mug?

Sometimes we just can’t see the forest for the trees. We become so accustomed to what we do each day that we can overlook what can be choking off our growth – or potentially fueling it to the next level. Plus, we are busy.

Half the battle of growing your business is in squarely observing what is in the way, as well as recognizing what are your greatest resources.  Only then can you effectively set your goals.

To help with this, we have developed a practice assessment specifically for chiropractic businesses. It digs into your office and measures 11 different dimensions of your operation.  Our first version of this was created nearly 14 years ago and has been used successfully since. This new version is even better.

Much like a functional assessment for your patients, this survey inspects vital areas of your practice and gives each a score. From this, we make a chart that gives you a portrait of what areas are strong and what may need immediate attention.  We also provide a written interpretation of the assessment.

Originally, this assessment was used with our active clients as part of their service. Using this assessment tool as well as practice statistics, we could uncover what areas of their business needed the most correction. We also discovered untapped or underutilized strengths that could help energize the office. At regular intervals, we could reassess and note the improvements and what to work on again.

We are now offering this assessment again as a special service which includes:

  1. The assessment
  2. Graded and plotted assessment
  3. Statistical analysis with charts
  4. Phone consultation
  5. Written report with practical action steps.

Each question will provoke a greater understanding of your practice. With the results of the assessment charted and the consultation, you will obtain a new perspective of how your office operates. You will also see more clearly what needs to be done to bring it to the level of success that you desire.

Practice Statistics. Of course, you can’t evaluate a business without also analyzing its performance monitors. Most offices keep practice numbers – somewhere.  Unfortunately, they are rarely reviewed properly.  We know how to analyze them and show you your ratios and the trends that they reveal. If we do not have your current practice statistics already, we will request them on a separate form. After interpreting your statistics, we plot them on charts and correlate them with the results of your Practice Development Assessment.  Together, this will allow us to give you an excellent overall analysis of your business and what needs to be done to take it to the next level.

 

Send in when Completed.  When you have completed this assessment, you can fax or email it back to us at Services @ pmaworks.com or Fax: 877-868-0909.   We will score and chart each section of your assessment and set up a time to discuss the outcomes with you. We will also send you the results with our written observations and recommendations.

The standard fee for this for non active clients is $250.  

NOTE: As of January, 2014, for a limited time promotion, we will be charging only $25. This is almost free, but I don’t want to take up our team’s time with people who aren’t seriously interested in this service. If you take us up on this assessment, I will assume you are hard core about improving your business. As hard core as we are!  🙂 Use the promo code  CPDAPROMO to get the discount when you click the link below.

Ed Petty

To purchase: LINK

 

 

Using Checklists to Improve Your Chiropractic Practice

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We are what we repeatedly do. Excellence, then, is not an act, but a habit.  ~Aristotle

Don’t overlook the humble checklist as an important tool in developing your business. Simple and low tech, the checklist is yet so powerful and vital that everyone from pilots to surgeons use them.

Here at Petty, Michel and Associates, we have been promoting the use of checklists as a simple tool in chiropractic practice development since the early 1990’s.  All successful businesses use them, and certainly all professionals, from airplane pilots to cowboys.

Are they just more paperwork? Or can they really make things faster, simpler, and actually improve the quantity and quality of your services?

It really is just a simple matter of helping to ensure that your office continues to do the things that work.

Let’s be honest: sooner or later, we all get bored.  When we start something new, we are fully engaged. But after a few weeks, months, let alone years, continuing to do the same thing can be painfully tedious. So much so that we are tempted to follow other diversions.

Excellence does require creativity and innovation. But it also requires doing the same thing that worked yesterday – today and tomorrow. Improve upon it; add a new service or product or communication channel.  But don’t let your feelings of monotony dictate your management planning or procedures.

At PM&A, we advocate management by the numbers and by your own proven procedures.  Execute your procedures routinely with care and interest. Don’t manage by emotions or chase other people’s bright ideas or change everything to follow the current management flavor of the day.

The fundamentals ALWAYS apply.

This is the meaning of what Aristotle spoke of as recorded in his talk on ethics:

We are what we repeatedly do. Excellence, then, is not an act, but a habit.

Practically, a checklist is a reminder of a what should be a habit: “Don’t forget to:____. ”  We are all busy and sometimes can take things for granted or take necessary shortcuts.  There is a tendency for any activity to atrophy to its minimal functions. For example, at the beginning of the year you got up early, had a cup of freshly ground coffee, and went to the gym for 40 minutes. By July, you were settling for instant coffee and a walk to and from your car.

A simple list of duties, such as how to open and “start” the office in the morning, “closing” the office in the evening, or “10 things to do on a patient financial consultation” can act to help train and as well as review excellence in performance. A list of duties for each position in the office is also very useful for training and just reminding.

Atul Gawande, an endocrine surgeon, saw the need for checklists in surgery.  He surveyed  fellow surgeons who said that they did not want to do checklists before surgery. But when asked if they wanted their surgeons to use a checklist if and when they went under the knife, almost all said they wanted their surgeons to use a checklist.

“What is needed… is discipline.

Discipline is hard — harder than trustworthiness and skill and perhaps even than selflessness.  

We are by nature flawed and inconstant creatures. We can’t even keep from snacking between meals.  We are not built for discipline. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at.

Good checklists, on the other hand are precise. They are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything–a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and important steps–the ones that even the highly skilled professional using them could miss.

Good checklists are, above all, practical.

                                     -Atul Gawande, M.D., Endocrine Surgeon, Associate Professor at Harvard. (author of The Checklist Manifesto)

Managing the work you do as a chiropractor or chiropractic team member in your office may not be as complicated as surgery, but your patients are just as important.   Maybe even more important.  Why? Because your chiropractic care may help keep your patients from ever needing surgery.

The Checklist: a simple and humble tool to improve the quality and quantity of your chiropractic services.

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Links to Atul Gawande: Quotes, TED